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Maintenance Treatment of Multiple Myeloma (MM) After Autologous Peripheral Blood Transplant (PBSCT) Using Polyethylene Glycol alpha2B Interpheron (PEG-INTRON)

Primary Purpose

Multiple Mieloma

Status
Unknown status
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
PEG-Intron sc injection
Sponsored by
Fundación de Investigación Biomédica - Hospital Universitario de La Princesa
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Mieloma focused on measuring Multiple Mieloma, PEG-Intron

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients ≤ 65 years old diagnosed with multiple myeloma in stage II or III of Durie-Salmon staging.
  • Patients who have achieved a complete response, partial after a myelosuppressive chemotherapy treatment followed by infusion of peripheral blood progenitor cells as first-line treatment. The criteria used to define the complete or partial response are the EBMT, ABMTR IBMTR and set out in the criteria paper of Bladé J, Samson D, Reece D, et al 1998
  • Subjects must have a Karnofsky performance status ≥ 60% at the time of joining the program.
  • Subjects must have adequate renal and hepatic function, defined as <2 times the upper limit of normal laboratory.
  • Subjects must have adequate hematologic function, defined as: platelets> 50,000/μl, ≥Hemoglobin 9.0 g/dl, total leukocyte account> 2.000/μl
  • No history of any cancer within the past 5 years except squamous cell carcinoma or basal cell skin or cervical carcinoma in stage I or in situ.
  • No history of hypersensitivity to interferon alfa or any other part of the injection.
  • No severe clotting disorders, thrombophlebitis or pulmonary embolism, or decompensated liver disease.
  • Pregnant or lactating at the time of diagnosis can not participate in this therapeutic program. During the same, men and women participants should not conceive children. Also, women who become pregnant will be withdrawn from the protocol.
  • Obtaining informed consent.

Exclusion Criteria:

  • Patients > 65 years old.
  • Patients with multiple myeloma stage I of Durie-Salmon staging system.
  • Patients who have not achieved a complete or partial response after a myelosuppressive chemotherapy regimen followed by infusion of progenitor cells from peripheral blood autologous treatment of any kind is allowed intensification of chemotherapy and pretransplant conditioning regimen. The criteria used to define the complete or partial response are the EBMT, ABMTR IBMTR and set out in the criteria paper of Bladé J, Samson D, Reece D, et al 1998
  • Treatment with any investigational drug within 30 days prior to the addition to this protocol.
  • Subjects with severe cardiovascular disease.
  • Subjects with a history of neuropsychiatric disorder that requires hospitalization.
  • Subjects with thyroid dysfunction or uncontrolled diabetes mellitus (refractory to treatment).
  • Subjects with active infection and / or uncontrolled.
  • Pregnant or lactating women or women of childbearing age not practicing effective contraception.
  • Patients with previous psychiatric disease, especially moderate or severe depression or a history of severe psychiatric disorder, including psychosis, suicidal thoughts or suicide attempts. In severe depression cover the following points: (a) hospitalization for depression (b) electroconvulsive therapy for depression or (c) depression leading to the prolonged absence at work or to alter significantly the daily functions. Can be consider the entrance into the study of subjects with mild depression, where it is demonstrated by pre-treatment assessment individual's emotional state is clinically stable and in which case a treatment program formulated for the patient who will become part of the patient's medical record.

Sites / Locations

  • Hospital Universitario de La Princesa

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

All patients are receiving PEG-Intron

Arm Description

Outcomes

Primary Outcome Measures

Time to Progression (TTP) and WHO (World Health Organization) Toxicity scale
Evaluate the number of Participants with Adverse Events, and provide guidelines for treatment with PEG-Intron (either in association with corticosteroids and / or bisphosphonate), administered weekly to patients with multiple myeloma who have achieved a complete or partial response after a myelosuppressive chemotherapy regimen, followed by an infusion of autologous peripheral blood progenitor cell (PBSCT) as treatment intensification.

Secondary Outcome Measures

Increase of Response (anti-tumoral effect) and Dose Tolerance
Evaluate the anti-tumor efficacy of this maintenance treatment

Full Information

First Posted
March 11, 2011
Last Updated
March 30, 2011
Sponsor
Fundación de Investigación Biomédica - Hospital Universitario de La Princesa
Collaborators
Haematology Service,
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1. Study Identification

Unique Protocol Identification Number
NCT01325896
Brief Title
Maintenance Treatment of Multiple Myeloma (MM) After Autologous Peripheral Blood Transplant (PBSCT) Using Polyethylene Glycol alpha2B Interpheron (PEG-INTRON)
Official Title
Maintenance Treatment of Multiple Myeloma (MM) After Autologous Peripheral Blood Transplant (PBSCT) Using Polyethylene Glycol alpha2B Interpheron (PEG-INTRON)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2011
Overall Recruitment Status
Unknown status
Study Start Date
September 2002 (undefined)
Primary Completion Date
March 2012 (Anticipated)
Study Completion Date
March 2012 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Fundación de Investigación Biomédica - Hospital Universitario de La Princesa
Collaborators
Haematology Service,

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Multiple myeloma accounts for approximately 1% of all cancers and 10% of hematologic malignancies. Between 50 and 70% of symptomatic patients presented response to induction chemotherapy. The rate of complete responses (CR) achieved with standard induction of these treatments is less than 5% of cases and the median event-free survival between 2 and 3 years although most of the patients died from the disease. High dose chemotherapy with autologous stem cell transplant has improved the response rate and survival of patient with MM. However eventually all patients relapse with a median EFS between 40-50 months post-transplant. To improve these results and sustain remission, various maintenance treatment have been proposed as is the case of Interpheron alpha2b s.c. (Intron A) that has shown benefits in a meta-analysis. Intron A s.c. need administration of 3 days per week and is not well tolerated Recently a new formulation of Interpheron alpha2b is available. Conjugated with polietilenglicol (Pegintron) that need only one dose weekly and has not been tested in MM. The purpose of this study is to evaluate the role of Pegintron as maintenance after autologous transplant in MM

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Mieloma
Keywords
Multiple Mieloma, PEG-Intron

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
33 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
All patients are receiving PEG-Intron
Arm Type
Other
Intervention Type
Drug
Intervention Name(s)
PEG-Intron sc injection
Intervention Description
This program is only open to patients with multiple myeloma who have achieved a complete or partial response after a myelosuppressive chemotherapy regimen followed by autologous stem cell infusion of peripheral blood transplant (PBSCT) as treatment intensification. These patients will be treated with PEG-Intron as maintenance therapy, to be permitted during the same concomitant administration of corticosteroids and / or bisphosphonates. PEG-Intron: 35 mcg per week by subcutaneous injection to progression or recurrence of the disease, or for 5 years maximum. Patients were administered PEG-Intron to a uniform dose of 15 mg initial week for 2 weeks. If this dose is tolerated, it would be gradually increased to 25 mg and then to 35 mg every 2 weeks, assuming that there is no toxicity of grade 3 or worse.
Primary Outcome Measure Information:
Title
Time to Progression (TTP) and WHO (World Health Organization) Toxicity scale
Description
Evaluate the number of Participants with Adverse Events, and provide guidelines for treatment with PEG-Intron (either in association with corticosteroids and / or bisphosphonate), administered weekly to patients with multiple myeloma who have achieved a complete or partial response after a myelosuppressive chemotherapy regimen, followed by an infusion of autologous peripheral blood progenitor cell (PBSCT) as treatment intensification.
Time Frame
three years
Secondary Outcome Measure Information:
Title
Increase of Response (anti-tumoral effect) and Dose Tolerance
Description
Evaluate the anti-tumor efficacy of this maintenance treatment
Time Frame
three years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients ≤ 65 years old diagnosed with multiple myeloma in stage II or III of Durie-Salmon staging. Patients who have achieved a complete response, partial after a myelosuppressive chemotherapy treatment followed by infusion of peripheral blood progenitor cells as first-line treatment. The criteria used to define the complete or partial response are the EBMT, ABMTR IBMTR and set out in the criteria paper of Bladé J, Samson D, Reece D, et al 1998 Subjects must have a Karnofsky performance status ≥ 60% at the time of joining the program. Subjects must have adequate renal and hepatic function, defined as <2 times the upper limit of normal laboratory. Subjects must have adequate hematologic function, defined as: platelets> 50,000/μl, ≥Hemoglobin 9.0 g/dl, total leukocyte account> 2.000/μl No history of any cancer within the past 5 years except squamous cell carcinoma or basal cell skin or cervical carcinoma in stage I or in situ. No history of hypersensitivity to interferon alfa or any other part of the injection. No severe clotting disorders, thrombophlebitis or pulmonary embolism, or decompensated liver disease. Pregnant or lactating at the time of diagnosis can not participate in this therapeutic program. During the same, men and women participants should not conceive children. Also, women who become pregnant will be withdrawn from the protocol. Obtaining informed consent. Exclusion Criteria: Patients > 65 years old. Patients with multiple myeloma stage I of Durie-Salmon staging system. Patients who have not achieved a complete or partial response after a myelosuppressive chemotherapy regimen followed by infusion of progenitor cells from peripheral blood autologous treatment of any kind is allowed intensification of chemotherapy and pretransplant conditioning regimen. The criteria used to define the complete or partial response are the EBMT, ABMTR IBMTR and set out in the criteria paper of Bladé J, Samson D, Reece D, et al 1998 Treatment with any investigational drug within 30 days prior to the addition to this protocol. Subjects with severe cardiovascular disease. Subjects with a history of neuropsychiatric disorder that requires hospitalization. Subjects with thyroid dysfunction or uncontrolled diabetes mellitus (refractory to treatment). Subjects with active infection and / or uncontrolled. Pregnant or lactating women or women of childbearing age not practicing effective contraception. Patients with previous psychiatric disease, especially moderate or severe depression or a history of severe psychiatric disorder, including psychosis, suicidal thoughts or suicide attempts. In severe depression cover the following points: (a) hospitalization for depression (b) electroconvulsive therapy for depression or (c) depression leading to the prolonged absence at work or to alter significantly the daily functions. Can be consider the entrance into the study of subjects with mild depression, where it is demonstrated by pre-treatment assessment individual's emotional state is clinically stable and in which case a treatment program formulated for the patient who will become part of the patient's medical record.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Adrián Alegre Amor, Physician Doctor
Organizational Affiliation
Hospital Universitario de La Princesa (Madrid, Spain)
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
José García Laraña, Physician
Organizational Affiliation
Hospital Ramón y Cajal. Madrid, Spain
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Juan José Lahuerta, Physician Doctor
Organizational Affiliation
Hospital 12 de Octubre. Madrid, Spain
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jesús San Miguel, Physician Doctor
Organizational Affiliation
Hospital Clínico Universitario. Salamanca, Spain
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Universitario de La Princesa
City
Madrid
ZIP/Postal Code
28006
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
9753033
Citation
Blade J, Samson D, Reece D, Apperley J, Bjorkstrand B, Gahrton G, Gertz M, Giralt S, Jagannath S, Vesole D. Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Myeloma Subcommittee of the EBMT. European Group for Blood and Marrow Transplant. Br J Haematol. 1998 Sep;102(5):1115-23. doi: 10.1046/j.1365-2141.1998.00930.x. No abstract available.
Results Reference
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PubMed Identifier
11313685
Citation
Bjorkstrand B, Svensson H, Goldschmidt H, Ljungman P, Apperley J, Mandelli F, Marcus R, Boogaerts M, Alegre A, Remes K, Cornelissen JJ, Blade J, Lenhoff S, Iriondo A, Carlson K, Volin L, Littlewood T, Goldstone AH, San Miguel J, Schattenberg A, Gahrton G. Alpha-interferon maintenance treatment is associated with improved survival after high-dose treatment and autologous stem cell transplantation in patients with multiple myeloma: a retrospective registry study from the European Group for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant. 2001 Mar;27(5):511-5. doi: 10.1038/sj.bmt.1702826.
Results Reference
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Maintenance Treatment of Multiple Myeloma (MM) After Autologous Peripheral Blood Transplant (PBSCT) Using Polyethylene Glycol alpha2B Interpheron (PEG-INTRON)

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